Paul Benjamin Mincy, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2360-C Issued in AR

Practice address

1100 N College Ave
Fayetteville, AR 72703-1944

Phone

(479) 443-4301

NPI assigned

Sep 7, 2017

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1504742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1801314026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 N COLLEGE AVE",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727031944",
            "telephone_number": "870-489-7927",
            "fax_number": "479-587-5916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N COLLEGE AVE",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727031944",
            "telephone_number": "479-443-4301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1461 Aniston Rd",
            "address_purpose": "LOCATION",
            "city": "Centerton",
            "state": "AR",
            "postal_code": "727196001",
            "country_code": "US",
            "telephone_number": "870-489-7927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MINCY",
        "first_name": "PAUL",
        "middle_name": "BENJAMIN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "2360-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ashley Dawn Mills, B.A.
• Breanna Mills, APRN, FNP-C
• Stacie M Mills
• Mary Grace Millwee, PHARM.D.
• Mindful Futures LLC
• Mindy Wilkerson, LCSW, PLLC
• Juliette Smith Minkel, MS, M.ED, LPC,RPT-S
• Mission Family Practice PLLC
• Banford Raye Mitchell, M.D.

• Clinical Social Worker in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.